Full-mouth scaling and root planing in type 2 diabetic subjects: one-year microbiological outcomes

Abstract

Background: This study evaluated the microbiological effects of full-mouth (FM) and partial-mouth (PM) scaling and root planing (SRP) in type 2 diabetic subjects with chronic periodontitis (ChP), up to 12 months. Methods: Thirty-four type 2 diabetic subjects with ChP received either FMSRP (n = 17), in two sessions within two consecutive days, or PMSRP (n = 17) in four sessions within 21 days. Six subgingival biofilm samples per subject were analysed by checkerboard DNA-DNA hybridization for 40 bacterial species at baseline, 3 and 12 months. Results: Both therapies significantly reduced the levels of the red complex species up to 12 months (p < 0.05). The levels of three putative pathogens from the orange complex were significantly reduced in the FMSRP group, whereas a single orange complex species was significantly decreased in the PMSRP group (p < 0.05). Furthermore, the proportions of the host-compatible Actinomyces species were significantly increased in both groups at 3 and 12 months. No significant differences were observed between groups for the counts and proportions of the individual species and the proportions of microbial complexes at any time point (p > 0.05). Conclusions: There were no differences in the bacterial species evaluated after FMSRP and PMSRP in the treatment of type 2 diabetic subjects with ChP, up to 12 months.

Did Omics change periodontal therapy?

“…In light of treatment, it is important to note that the vast majority of the data available on the microbial effects of periodontal treatment (elimination/suppression postulate) were obtained using checkerboard DNA-DNA hybridization. This technique was used to determine the microbial shifts subsequent to scaling and root planing alone, 92,98,100,[171][172][173][174][175][176][177] with adjunctive local and /or systemic antimicrobials, 22,23,25,98,100,110,111,150,176,[178][179][180][181][182] , and surgical 23,181,183,184 and laser [185][186][187][188] increase in the proportions of Actinomyces species. 22,23,110,111 Because 16S sequencing allows the entire bacterial community to be studied simultaneously, rather than only a subset of pathogenic species, this created an unprecedented opportunity for ecological investigation of the periodontal microbiome.…”

“…In light of treatment, it is important to note that the vast majority of the data available on the microbial effects of periodontal treatment (elimination/suppression postulate) were obtained using checkerboard DNA‐DNA hybridization. This technique was used to determine the microbial shifts subsequent to scaling and root planing, alone 92,98,100,171‐177 with adjunctive local and/or systemic antimicrobials, 22,23,25,98,100,110,111,150,176,178‐182 , and surgical 23,181,183,184 and laser 185‐188 approaches. Collectively, these studies demonstrated that the 40 bacterial species from the checkerboard panel serve as an excellent thermometer of treatment efficacy.…”

Clinical efficacy of semiconductor laser-assisted minocycline in moderate-to-severe chronic periodontitis patients with type 2 diabetes mellitus

“…A total of 109 CP patients with T2DM and obesity, admitted in our hospital from November 2016 to November 2017 were the study participants. The inclusion criteria were: (1) eligibility for the diagnosis of chronic periodontitis [7]; eligibility for the diagnosis of type 2 diabetes mellitus (T2DM); (3) obesity with BMI > 28; (4) age > 18 years; (5) regular hypoglycemic treatment for diabetes for stable blood glucose control; and (6) signing of an informed consent. The exclusion criteria were: (1) remaining teeth < 20; (2) pregnant or lactating women; (3) periodontal therapy within three months before the study; and (4) intake of antibiotics within the previous one month.…”

“…Chronic periodontitis increases levels of inflammatory factors and impedes glucose metabolism through insulin resistance (IR), thereby aggravating T2DM [4]. Type 2 diabetes mellitus impacts on oral flora, contributes to their attachment, and weakens the body's ability to fight infection, thereby exacerbating CP.…”

Effects of mouthwash on periodontal pathogens and glycemic control in patients with type 2 diabetes mellitus

“…Recently, it has been reported that patients with T2DM treated for periodontitis have reduced periodontopathic bacteria and improved glycemic control [22][23][24][25]. Patients with T2DM complicated by periodontitis have more red complex species, and poor glycemic control is thought to be associated with increased levels of red complex species in the oral cavity [26].…”